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Pediatr Surg Int 2022 Jun 13;38(6):935-939. Epub 2022 Apr 13.

Departments of Pediatric Urology and Radiology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116, India.

Background/aims: Prompt and early treatment of valve bladder is known to improve renal outcome in patients with PUV. We hypothesized that bladder height width ratio (HWR) measurement on voiding cystourethrogram (VCUG) could predict development of valve bladder.

Methods: All patients who underwent primary PUV ablation and evaluated later with urodynamics were included. Read More

Urol Case Rep 2022 Jul 9;43:102053. Epub 2022 Mar 9.

Pediatric Urology Research Center, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.

Concomitant anterior urethral valve and diverticulum (AUVD) and posterior urethral valve (PUV) is an extremely uncommon congenital anomaly that causes infra-vesical obstruction. We present our experience with one case of concomitant AUVD and PUV as well as the related literature review. Early diagnosis and successful management of these anomalies can improve renal function and prevents recurrent urinary tract infections and subsequent renal failure. Read More

BMJ Case Rep 2022 Jan 17;15(1). Epub 2022 Jan 17.

Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia

Congenital obstructive uropathy is a rare cause of ascites in infants. Majority of reported cases of genitourinary causes of ascites were due to posterior urethral valve. Here, we report a 6-month-old boy who presented with progressive tense ascites and peritonitis attributed by unilateral left distal ureteric obstruction and acute pyonephrosis. Read More

BMJ Case Rep 2021 Sep 22;14(9). Epub 2021 Sep 22.

Department of Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.

We describe a case of a 3-year-old boy with Down syndrome who developed a bladder rupture as a consequence of an undiagnosed posterior urethral valve (PUV). He had a history of urinary tract infections and constipation and was acutely admitted in poor condition and underwent laparotomy that revealed peritoneal sepsis secondary to bladder perforation. Bladder was drained using a suprapubic catheter and the condition of the boy gradually improved. Read More

Ann Ib Postgrad Med 2020 Dec;18(2):170-177

OMVIAL 3D Fetal Diagnostic Centre, Ibadan.

Introduction: Two-Dimensional ultrasound (2DUS) has been the preferred screening method for fetal abnormalities for several decades. Three-dimensional ultrasound (3DUS) is a technique that converts standard 2D grayscale ultrasound images into a volumetric dataset which allows visualization of the fetus in all three dimensions at the same time. It provides an improved overview and a more clearly defined demonstration of adjusted anatomical planes. Read More

Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021 Apr 23;42(1):77-81. Epub 2021 Apr 23.

University Children's Hospital, Medical Faculty Skopje, RN Macedonia.

Multicystic dysplastic kidney is a rare congenital anomaly of the kidney and urinary tract. The association with the posterior urethral valve is also very rare. Here we present a patient with both entities and prenatal resolution of the cysts. Read More

Ann R Coll Surg Engl 2021 Apr 4;103(4):e114-e115. Epub 2021 Mar 4.

Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK.

Neuropathic bladder may be a co-associated morbidity in newborn babies following resection of a sacrococcygeal teratoma. We report a case of a male newborn showing features of incomplete urinary voiding requiring intermittent catheterisation after operation for bladder emptying. Videourodynamic assessment excluded neuropathic bladder and posterior urethral valves were demonstrated on micturating cystography. Read More

J Pediatr Urol 2021 04 27;17(2):231.e1-231.e7. Epub 2021 Feb 27.

Pediatric Urology Department Meyer Children Hospital, viale Pieraccini 24, Firenze, 50139, Italy.

Introduction: Anterior urethral valves (AUV) are a rare cause of lower urinary tract obstruction which could progress to renal damage, Clinical presentation varies according with patient's age and severity of obstruction, but, in most cases, diagnosis is based on voiding cysto-urethrogram (VCUG). To date, the treatment of choice is endoscopic ablation even if approved guidelines about the overall management of AUVs, including the recognition and treatment of residual valves, are not available.

Objective: We describe our protocol for AUV treatment based on primary endoscopic valve ablation followed by check cystoscopy 15 days later. Read More

J Endourol Case Rep 2020 29;6(4):362-365. Epub 2020 Dec 29.

Department of Radiodiagnosis, DODA Imaging, Pusa Road, New Delhi, India.

Multiple urethral anomalies are rare with its own challenges in diagnosis and management. The double urethral obstructions are often missed as proximal obstruction can mask the early diagnosis of distal obstruction. We present a rare case of concomitant posterior urethral valve (PUV) and anterior urethral valve (AUV) with a large anterior urethral diverticula (AUD) and hypospadias. Read More

J Pediatr Urol 2021 Feb 6;17(1):111.e1-111.e8. Epub 2020 Nov 6.

Calcutta Medical Research Institute, 7, 2, Diamond Harbour Rd, New Alipore, Kolkata, West Bengal 700027, India. Electronic address:

Introduction: Detrusor dysfunction is known to persist in several patients of Posterior Urethral Valve (PUV) after successful fulguration leading to progressive deterioration of renal function. Persistent bladder outlet obstruction (BOO) in the form of bladder neck hypertrophy, residual valves or strictures may contribute to progressive detrusor dysfunction. These are assessed radiologically or cystoscopically and are managed variedly by anticholinergics, alpha-adrenergic blockers or even bladder neck incision. Read More

J Pediatr Urol 2021 Feb 4;17(1):101.e1-101.e9. Epub 2020 Nov 4.

Department of Radiodiagnosis, DODA Imaging, PUSA Road, New Delhi, India.

Background: Anterior urethral valve (AUV) and anterior urethral diverticulum (AUD) are two rare causes of anterior urethral obstruction with variable presentation and anatomy. Their existence as the same or different entity is still debatable, and management has not yet been standardized.

Objective: This study is a retrospective review of cases diagnosed with anterior urethral obstruction and correlation of radiological and endoscopic anatomy of AUV and AUD. Read More

Urol J 2020 Sep 23;18(4):429-433. Epub 2020 Sep 23.

Division of Pediatric Urology, Pediatric Center of Excellence, Tehran University of Medical Sci-ences, No 62, Dr. Gharib's street, Keshavarz Blvd, PO Box: 1419733151, Tehran, Iran.

Purpose: Concurrent valve ablation and bladder neck incision is suggested as an effective and safe treatment approach in posterior urethral valve children with prominent bladder neck. We evaluated chronic kidney disease risk factors in these children.

Materials And Methods: We retrospectively reviewed medical records of children with posterior urethral valve and included those younger than 18 years old who underwent valve ablation and bladder neck incision at our institution. Read More

Early Hum Dev 2020 11 10;150:105189. Epub 2020 Sep 10.

Chelsea and Westminster and Imperial College Hospitals, United Kingdom of Great Britain and Northern Ireland; Imperial College London, United Kingdom of Great Britain and Northern Ireland. Electronic address:

Fetal lower urinary tract obstruction (LUTO) is classically based on prenatal ultrasound identification of a dilated/ thick-walled bladder, bilateral hydronephrosis, dilated ureters and a dilated posterior urethra (also known as the "keyhole sign") in a male fetus. Although the most common underlying diagnosis is posterior urethral valves, the prenatal appearance may be similar with urethral atresia or stenosis, the Prune-Belly Syndrome, or even a cloacal anomaly in a female. These conditions form part of the Congenital Anomalies of Kidney and Urinary Tract (CAKUT) spectrum, which is the commonest cause of end-stage renal disease in children. Read More

Pediatr Neurosurg 2020 7;55(4):210-214. Epub 2020 Sep 7.

Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Introduction: Cavernous malformation (CM) of the pediatric spine is uncommon, and its presentation especially in infancy is extremely rare. We report an unusual case of thoracolumbar intramedullary CM with hemorrhage in a 5-month-old male child.

Case Presentation: The child presented with the predominant symptom of urinary retention, and the underlying neurological cause was initially overlooked. Read More

Saudi Med J 2020 Sep;41(9):1011-1014

Male Genital Reconstruction/Sexual Medicine & Minimal invasive Urology, College of Medicine, Taibah University, Madinah, Kingdom of Saudi Arabia. E-mail.

Posterior urethral valves (PUVs) are frequently recognized during the perinatal period. Delayed diagnosis is reported usually within the first decade of life with diverse clinical presentations. In the current case report, we describe a 45 years old man patient who presented with aspermia and primary infertility for 8 years in whom his diagnostic workup revealed radiological imaging suggestive of PUVs. Read More

J Pediatr Urol 2020 Aug 3;16(4):488.e1-488.e8. Epub 2020 Jun 3.

Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA. Electronic address:

Background: Pressure pop-offs, such as high-grade vesicoureteral reflux with renal dysplasia, have historically been considered beneficial for renal and bladder outcomes in boys with posterior urethral valves (PUV). Recent longer-term studies have called into question the beneficial effects of pop-offs on renal function.

Objective: To evaluate how pop-offs affect bladder outcomes in boys with PUV. Read More

J Pediatr Urol 2020 10 4;16(5):585.e1-585.e7. Epub 2020 Apr 4.

Department of Surgery, Texas Children's Hospital, USA; Scott Department of Urology, Baylor College of Medicine, USA.

Background: Anterior urethral valves (AUV) and associated anterior urethral diverticula (AUD) are a rare cause of congenital lower urinary tract obstruction. They occur 25-30 times less frequently than posterior urethral valves (PUV) and historically tend to have a less aggressive presentation and outcome. However, due to the low incidence, little is known about management and long-term prognosis. Read More

Niger Med J 2019 Nov-Dec;60(6):306-311. Epub 2020 Feb 24.

Department of Surgery, Division of Paediatric Surgery, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Background: Posterior urethral valve (PUV) is a significant cause of morbidity and mortality among male children resulting in renal failure in 25%-30% before adolescence irrespective of initial treatment. This study aimed at evaluating the early outcomes of children managed for PUV.

Materials And Methods: This was a prospective study of all children who were treated for PUV between 2012 and 2016 at a single referral institution. Read More

Cir Pediatr 2020 Jan 20;33(1):36-42. Epub 2020 Jan 20.

Radiologic Department's. Complejo Hospitalario Universitario de Albacete. Albacete (Spain).

Objectives: Report our experience with the use of contrast-enhanced serial voiding urosonography (SVU) for posterior urethral valve (PUV) patient diagnosis and management.

Material And Methods: Descriptive retrospective study in 0- to 14-year-old patients with suspected PUV at SVU performed as a first contrast-enhanced urinary tract test with subsequent cystoscopic study. Variables were analyzed using SPSSv22. Read More

Urology 2020 06 19;140:159-161. Epub 2020 Feb 19.

Department of Urology, Sri Sathya Sai Institute of Higher Medical Sciences, Prashantigram, Puttaparthi, Andhra Pradesh, India. Electronic address:

Anterior urethral valves are a rare cause of obstructed voiding in adolescent children and are often unheard by adult urologists. In this case report, we discuss the management of two adolescent patients who were referred to us with obstructive voiding symptoms with a diagnosis of neurogenic bladder and posterior urethral valves respectively but on evaluation were found to have anterior urethral valves. This article highlights the need for considering anterior urethral valve as an important differential diagnosis in children and adolescents presenting with obstructive voiding symptoms so as to avoid delay in diagnosis and management in young boys. Read More

Pediatr Radiol 2020 04 9;50(4):575-582. Epub 2019 Nov 9.

Service de Radiologie, Hôpital d'Enfants Armand-Trousseau APHP, Sorbonne Université, Paris, France.

A wide range of genitourinary pathologies can be diagnosed in utero, from a simple vesicoureteral reflux to a more complex disorder of sexual differentiation. The prognosis and neonatal management of these conditions differ significantly. Evaluation of the fetal perineal anatomy is paramount to making the right diagnosis. Read More

Ethiop J Health Sci 2019 Sep;29(5):591-596

Department of Radiology, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia.

Background: Most congenital anomalies of the urinary tract present with hydronephrosis. Some are physiological while others pathological. Ultrasound, micturating cyst urethrography, dynamic renal scintigraphy, intravenous urography, dynamic and static magnetic resonance urography are used for examination. Read More

BMJ Case Rep 2019 Jul 23;12(7). Epub 2019 Jul 23.

Paediatric Urology, Evelina London Children's Healthcare, London, UK.

We present a rare case of association of anterior rectal duplication and posterior urethral valve (PUV). A term neonate with no antenatal concerns was admitted with urosepsis and acute renal injury at 18 days of age. History revealed a poor urinary stream and dribbling. Read More

J Pediatr Urol 2019 Aug 4;15(4):379.e1-379.e8. Epub 2019 Apr 4.

Urology and Nephrology Research Center, Department of Urology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Neuropathic bladder, voiding dysfunction, and posterior urethral valves may cause a great challenge in children. Preserving the kidney function is the main aim in all of these patients which can be achieved by cutaneous vesicostomy.

Objective: The objective of this study is to evaluate the long-term outcomes of patients who have undergone cutaneous vesicostomy in an 11-year period at the study center. Read More

Ultrasound Obstet Gynecol 2020 07;56(1):86-95

EA 7328-PACT, Paris Descartes University, Sorbonne Paris Cité, Imagine Institue, Paris, France.

Objectives: Incompatibility between currently available fetoscopes and the anatomical constraints of the distended fetal bladder, with the resulting curvature around the bladder neck, account for most technical difficulties during fetal cystoscopy in lower urinary tract obstruction (LUTO). The aim of this anatomical study was to assess by magnetic resonance imaging (MRI) the variation in three bladder angles (bladder-neck angle (BNA), vesicourethral angle (VUA) and angle between bladder dome and posterior urethra (DUA)), according to gestational age (GA), bladder volume and the presence of LUTO.

Methods: From our fetal medicine database, we retrieved for review 46 MRI examinations of male fetuses between 2015 and 2019, including 17 with LUTO, examined at a mean GA of 28. Read More

Pediatr Int 2018 Dec;60(12):1090-1091

Department of Urology, Keio University School of Medicine, Tokyo, Japan.

BMJ Case Rep 2018 Sep 23;2018. Epub 2018 Sep 23.

Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Posterior urethral valve and foreign body are among the important causes of male urethral obstruction. Although one is congenital and the other is acquired, both entities are rare in children with only a few reported cases. Because of myriad of symptoms associated with both conditions, a conclusive diagnosis requires both physical examination and radiological imaging. Read More

Prog Urol 2018 Oct 3;28(12):596-602. Epub 2018 Jul 3.

Chirurgie viscérale infantile, hôpital Brabois Enfants, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France.

Introduction: Congenital Lower Urinary Tract Obstructions (LUTO) is a heterogeneous group of diseases in which urine elimination is obstructed at the level of bladder neck or urethra. The aim of the study is to evaluate the long-term renal outcome of patients suffering of congenital LUTO.

Patients And Method: We retrospectively reviewed patients with congenital LUTO. Read More

BMC Urol 2018 May 21;18(1):46. Epub 2018 May 21.

Departmennt of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.

Background: The incidence of posterior urethral valve (PUV) is estimated at 1:5000-1:8000 males. It is the most common paediatric urologic urgency and the most common cause of male obstructive uropathy and chronic renal failure in children. The study aimed to describe the experience of Yaoundé gynaeco-obstetrics and paediatric hospital in the management of PUV. Read More

Curr Urol Rep 2018 May 17;19(7):55. Epub 2018 May 17.

Division of Urology, Children's Hospital of Philadelphia, 3rd Floor Wood Center, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Purpose Of Review: The purpose of this review is to bring the reader up to date on the current risk factors for the development of renal deterioration in the boys with posterior urethral valves (PUV) and approaches to modify this risk.

Recent Findings: Renal bladder ultrasound (RBUS) is routinely performed in boys with PUV and recent advancements allow imaging processing that can more accurately quantify renal parenchyma and correlate this with risk for renal loss. Refinement of urine studies may improve our ability to stratify patients into renal loss categories. Read More